Update on COVID-induced cerebrovascular injuries
COVID-19 is more than a debilitating, sometimes fatal respiratory infection.
COVID-19 is more than a debilitating, sometimes fatal respiratory infection. Depending on the research study being reviewed, up to 70% of individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection develop cerebrovascular complications ranging from feeling out of sorts to dysautonomia and even stroke.
“The pathophysiology is still unclear,” said Avindra Nath, MD, chief of Infections of the Nervous System and Clinical Director of the National Institute of Neurological Disorders and Stroke. “We think microvascular disease has a huge role. Autopsy data from people who have died of COVID show hemorrhages, clotting in the small blood vessels, leakage of serum proteins and inflammation around endothelial cells. We think damage to endothelial cells is key.”
Dr. Nath will present the latest findings in microvascular injury associated with COVID-19 during “Mechanisms and Outcomes of Covid-Induced Cerebrovascular Injury” on Thursday from 7-8:30 a.m. CST. The symposium will explore critical illnesses, cerebrovascular and cognitive sequelae in COVID, vaccination and vaccine-induced thrombocytopenia, and neurologic complications and multisystem inflammatory syndrome in children (MIS-C).
More than two years into the pandemic, there are few solid answers when it comes to COVID complications, particularly for children. The typical adult critical care specialist has treated thousands of patients, and randomized controlled trials are informing treatment options, said Lori Jordan, MD, PhD, associate professor of pediatrics, neurology and radiology at Vanderbilt University Medical Center in Nashville. Dr. Jordan is also a symposium presenter and will address the topic of neurologic sequelae of SARS-CoV2 and MIS-C in children. The typical pediatric critical care specialist may have only cared for a few hundred children with COVID, she said. Also, randomized controlled trials for COVID-19 that include children are rare.
“Kids with MIS-C are much more ill and in the very high-risk group for serious neurologic complications,” she said. “The rate of any neurologic complication is probably around 60%; about 12% of those have some sort of truly life-threatening complication.”
Drs. Nath and Jordon will be joined by other faculty, including Jennifer Frontera, MD, NYU Langone Hospitals in Brooklyn, New York; Mona N. Bahouth, MD, PhD, assistant professor of neurology at Johns Hopkins Medicine in Baltimore, Maryland; Mary Cushman, MD, medical director of the thrombosis and hemostasis program and professor of medicine and pathology at the University of Vermont Medical Center in Burlington, Vermont; and Richa Sharma, MD, MPH, assistant professor at the Yale School of medicine in New Haven, Connecticut; for a dynamic session regarding this clinically important area for advancing patient care.